i need a secure automotive credit app

It must gather data from applicants and send this data securely to my clients.

It must be able to separate applicants by 1. campaign and 2. clients This can be accomplished by use of a "Pin Code". This Pin Code would be a variable number attached to a direct mailer (sent by USPS) or to email which would indicate the specific mailer campaign and the specific client. Most of our mailer campaigns are for more than one client.

I want to make sure that the data that we are gathering from the applicants, which will include their Social Security number and other sensitive information, cannot be compromised or stolen from the website or in the transfer to the client. And, the data must be automatically purged after 30 days.

Here are some example online automotive credit applications:

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This online credit application must be able to format correctly for use on a Smart Phone or iPad.

I need to have a backend access in order to add campaign names/numbers and dealer names / email addresses / passwords.

Additionally, I want to be able to view and print reports for each campaign to tell me how many total applicants and how many applicants for each client.

This application must be available, fully functional and tested for use by MAY 10